Development of methods of male contraception: impact of the World Health Organization Task Force

Objective: To give an historical record of the research of the World Health Organization (WHO) Task Force to develop methods of male contraception; to examine the social, political, medical, pharmaceutical, funding, and other factors that influenced progress; and to suggest reasons why such methods are only now becoming available. Design: Review of basic and clinical research over 30 years. Setting: Task force of a multinational agency and collaborating agencies. Conclusion(s): Through the involvement of many international scientists, the WHO Task Force has uniquely contributed to the exploratory phases of the research in male contraception and by its multicenter contraceptive efficacy studies has accelerated progress towards the ideal hormonal method. Despite an adverse climate involving social and political attitudes, funding constraints, and pharmaceutical industry hesitations, WHO formed coalitions with governments and international agencies to sustain research with results that apply to men in culturally diverse populations and thereby to influence activities across the whole range of global reproductive health and family planning.

Simple approach for the histomolecular diagnosis of central nervous system gliomas based on 2021 World Health Organization Classification

The classification of central nervous system(CNS)glioma went through a sequence of developments,between 2006 and 2021,started with only histological approach then has been aided with a major emphasis on molecular signatures in the 4^(th) and 5^(th) editions of the World Health Organization(WHO).The recent reformation in the 5th edition of the WHO classification has focused more on the molecularly defined entities with better characterized natural histories as well as new tumor types and subtypes in the adult and pediatric populations.These new subclassified entities have been incorporated in the 5^(th) edition after the continuous exploration of new genomic,epigenomic and transcriptomic discovery.Indeed,the current guidelines of 2021 WHO classification of CNS tumors and European Association of Neuro-Oncology(EANO)exploited the molecular signatures in the diagnostic approach of CNS gliomas.Our current review presents a practical diagnostic approach for diffuse CNS gliomas and circumscribed astrocytomas using histomolecular criteria adopted by the recent WHO classification.We also describe the treatment strategies for these tumors based on EANO guidelines.

Assessment of Medicines Cold Chain Storage Conformity with the World Health Organization Requirements in Health Facilities in Tanzania

A descriptive study on assessment of medicines cold chain storage conformity with World Health Organization (WHO) requirements in public health facilities was carried out in Dar es Salaam and Dodoma regions. Storage conformity in selected health facilities was assessed by monitoring temperature using temperature data loggers mounted in the refrigerators for a period of 30 days. Results indicated almost half of the health facilities 48.5% visited, did not significantly (P = 0.031) comply with storage temperature (+2°C to +8°C) as per WHO requirement because all recorded Mean Kinetic temperature (MKT) > 8°C. In rural areas, 59.2% of visited health facilities adhered to the WHO recommended storage temperature while in urban areas only 31.6% complied. The study has established electricity failure in urban and lack of gas in rural areas coupled with absence of contingency plan as major challenges to WHO temperature conformity in storage of cold chain medicines in health facilities in Tanzania.

Classificatory updates in verrucous and cuniculatum carcinomas:Insights from the 5^(th) edition of WHO-IARC head and neck tumor classification

The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.

The World Health Organization Surgical Safety Checklist Improves Post-Operative Outcomes: A Meta-Analysis and Systematic Review

Background: The incidence of in-hospital adverse events is about 10%, with a majority of these related to surgery, and nearly half considered preventable events. In attempts to improve patient safety, the World Health Organization (WHO) developed a checklist to be used at critical perioperative moments. This meta-analysis examines the impact of the WHO surgical safety checklist (SSC) on various patient outcomes. Methods: A comprehensive search of all published studies assessing the use of the WHO SSC in patients undergoing surgery was conducted. Studies using the WHO SSC in any surgical setting, with pre-implementation and post-implementation outcome data were included. The incidence of patient outcomes (total complications, surgical site infections, unplanned return to the operating room (OR) within 30 days, and overall mortality) and adherence to safety measures were analyzed. Results: 10 studies involving 51,125 patients (27,490 prior to implementation and 23,635 after implementation of the WHO SSC) were analyzed. The implementation of the WHO SSC significantly reduced the risk of total complications by 37.9%, surgical site infections by 45.5%, unplanned return to OR by 32.1%, and mortality by 15.3%. Increased adherence to safety measures including airway evaluation, use of pulse oximetry, prophylactic antibiotics when necessary, confirmation of patient name and surgical site, and sponge count was also observed. Conclusions: The use of the WHO SSC is associated with a significant reduction in post-operative complication rates and mortality. The WHO SSC is a valuable tool that should be universally implemented in all surgical centers and utilized in all surgical patients.

Resistance to clarithromycin and gastroenterologist's persistence roles in nomination for Helicobacter pylori as high priority pathogen by World Health Organization

Due to the increasing prevalence of clarithromycin resistance, future of management of Helicobacter pylori(H. pylori) infections need to be recognized. To now, clarithromycin was the best effective, well-tolerated and safe antibiotic used in treatment of the bacterium, but, increasing trend of resistance reduced efficacy of recommended regimens. Indeed, gastroenterologists are mostly unable to start appropriate therapyaccording to the sensitivity profile-due to the certain difficulties in routine H. pylori culture procedure and being time consuming method. This announcement by World Health Organization(WHO) was an onset to reconsider current challenging dilemma about H. pylori clarithromycin resistant isolates. Therefore, investigating of various factors affecting this nomination by WHO is highly welcomed. In fact, WHO enumerated more than 16 pathogens which seriously threats human life and public health, thus better management or effective guidelines are necessary. Here for the first time, we nominated this phenomenon as ‘‘gastroenterologist's persistence'' which should be equally investigated as antibiotic resistance. The ability of gastroenterologists to win the game against H. pylori infections is highly influenced by their collaboration with diagnostic laboratories to apply susceptibility patterns before any prescription. In conclusion, closer collaboration between two important partners(gastroenterologists and microbiologists) in management of H. pylori infection may hopefully trigger an era to remedy current crisis in clarithromycin resistance, a later gastric cancer can be practically preventable.

Mental health promotion for elderly populations in World Health Organization South-East Asia Region:Needs and resource gaps

The accelerated population growth of the elderly(individuals aged 60 years or more)across the globe has many indications,including changes in demography,health,the psycho-social milieu,and economic security.This transition has given rise to varied challenges;significant changes have been observed in regard to developing strategies for health care systems across the globe.The World Health Organization(WHO)is also engaging in initiatives and mediating processes.Furthermore,advocacy is being conducted regarding a shift toward the salutogenic model from the pathogenic model.The concept behind this move was to shift from disablement to enablement and from illness to wellness,with the notion of mental health promotion(MHP)being promoted.This article attempts to discuss the MHP of elderly individuals,with special reference to the need to disseminate knowledge and awareness in the community by utilizing the resources of the health sector available in the WHO South-East Asia Region countries.We have tried to present the current knowledge gap by exploring the existing infrastructure,human resources,and financial resources.There is much to do to promote the mental health of the elderly,but inadequate facilities are available.Based on available resources,a roadmap for MHP in elderly individuals is discussed.

The Influence of Socio-Demographic, Health and Work-Related Factors on Health-Related Quality of Life among Iranian Industrial Workers

Health-related quality of life (HRQOL) has not been investigated among Iranian industrial workers. The present paper aimed to study the influence of the socio-demographic, health and work-related factors on HRQOL among Iranian industrial workers. In this cross-sectional study, participants were 280 workers of two factories. The Persian version of World Health Organization Quality of Life-Brief (WHOQOL-BREF) was used to assess the HRQOL. A questionnaire was developed to assess the socio-demographic, health and work-related factors. Results showed that the means (SD) of physical health, psychological health, social relationships, and environment domains of HRQOL were 13.2 (2.7), 13.3 (2.6), 14.2 (3.5) and 12.6 (2.5), respectively. A multiple linear regression showed that types of job, exercise activity, working schedule, sleep quality, smoking, and conflict between work and social life were significantly associated with physical health domain;whereas, working schedule, marital status, working demand, sleep quality, BMI, and conflict between work and individual life were significantly associated with psychological health domain. Working schedule, working demand, sleep quality, conflict between work and individual life, and having children over two years were significantly associated with social relationship domain;however, working demand, working schedule, smoking, sleep quality, working hour, job satisfaction, marital status and exercise activity were significantly associated with environment domain. Collectively, work-related factors including unhealthy working conditions, unsafe working environments, long working hours, irregular working schedules, and the lack of occupational training may negatively influence the HRQOL of workers. To improve workers’ HRQOL, intervention programs should focus on improving work environment, working schedule, occupational training and restricting working hours.

The contribution of Asian scientists to global research in andrology

Aim: To present a personal account of the involvement of the World Health Organization (WHO) in the collaborativedevelopment in Asia of those areas of andrology concerned with male contraception and reproductive health.Methods: The andrology training through workshops and institution support undertaken by the WHO HumanReproduction Programme (HRP) and how they contributed to the strengthening of andrology research in Asia aresummarised. Results: The author's experience and the Asian scientific contributions to the global research in thefollowing areas are reviewed: the safety of vasectomy and the development of new methods of vas occlusion; gossypoland its failure to become a safe, reversible male antifertility drag; Tripterygium and whether its pure extracts will passthrough the appropriate toxicology and phased clinical studies to become acceptable contraceptive drugs; hormonalmethods of contraception for men. Conclusion: The WHO policy of research capacity building through training andinstitution strengthening, together with the collaboration of Asian andrologists, has created strong National institutionsnow able to direct their own programmes of research in clinical and scientific andrology.

Economic evaluation of the hepatitis C elimination strategy in Greece in the era of affordable direct-acting antivirals

BACKGROUND Hepatitis C virus(HCV) is a leading cause of worldwide liver-related morbidity and mortality. The World Health Organization released an integrated strategy targeting HCV-elimination by 2030. This study aims to estimate the required interventions to achieve elimination using updated information for direct-acting antiviral(DAA) treatment coverage, to compute the total costs(including indirect/societal costs) of the strategy and to identify whether the elimination strategy is cost-effective/cost-saving in Greece.AIM To estimate the required interventions and subsequent costs to achieve HCV elimination in Greece.METHODS A previously validated mathematical model was adapted to the Greek HCVinfected population to compare the outcomes of DAA treatment without the additional implementation of awareness or screening campaigns versus an HCV elimination strategy, which includes a sufficient number of treated patients. We estimated the total costs(direct and indirect costs), the disability-adjusted life years and the incremental cost-effectiveness ratio using two different price scenarios.RESULTS Without the implementation of awareness or screening campaigns,approximately 20000 patients would be diagnosed and treated with DAAs by2030. This strategy would result in a 19.6% increase in HCV-related mortality in2030 compared to 2015. To achieve the elimination goal, 90000 patients need to be treated by 2030. Under the elimination scenario, viremic cases would decrease by78.8% in 2030 compared to 2015. The cumulative direct costs to eliminate the disease would range from 2.1-2.3 billion euros(€) by 2030, while the indirect costs would be €1.1 billion. The total elimination cost in Greece would range from €3.2-3.4 billion by 2030. The cost per averted disability-adjusted life year is estimated between €10100 and €13380, indicating that the elimination strategy is very costeffective. Furthermore, HCV elimination strategy would save €560-895 million by2035.CONCLUSION Without large screening programs, elimination of HCV cannot be achieved. The HCV elimination strategy is feasible and cost-saving despite the uncertainty of the future cost of DAAs in Greece.

Minimizing the risk of international spread of coronavirus disease 2019 (COVID-19) outbreak by targeting travelers

The Coronavirus Disease-2019 (COVID-19) outbreak has become a global health emergency owing to its magnitude, attributed deaths, and its propensity to spread across the world. In-fact, owing to its quick spread across international boundaries and the resulting caseload, the disease has been declared as a Public Health Emergency of International Concern on 30 January 2020. It is worth noting that out of the 395 cases detected in other nations, 165 (41.8%) have a positive history of travel to China. As of now, the World Health Organization has not recommended for any restrictions on the travel or trade aspects, but has clearly specified that implementation of International Health Regulations should be strictly done at the airports and seaports. In conclusion, the COVID-19 outbreak has created an alarm across the globe as the causative virus is novel in nature. However, strengthening of standard infection control practices and adoption of preventive measures for travelers can significantly minimize the threat of further transmission of the disease.

Milestones in the discovery of hepatitis C

The discovery of hepatitis C has been a landmark in public health as it brought the opportunity to save millions of lives through the diagnosis,prevention and cure of the disease.The combined work of three researchers,Alter H,Houghton M and Rice C,which set the basis for the diagnosis,treatment and prevention of hepatitis C apart from laying the ground work for a new approach to study infections in general and developing new antiviral agents.This is a story of a transfusion-associated infection.A series of clinical studies demonstrated the existence of an infectious agent associated with hepatitis.That was followed by the identification of what was later known to be the hepatitis C virus(HCV)and the development of diagnostic tests.It all preceded the full molecular identification and demonstration of a causal effect.Finally it ended up with the development and discovery of a new class of therapeutic drugs,the direct acting antivirals,which are now used not only to cure the disease but most probably,to eliminate the problem.This work started with Dr Alter H who demonstrated that a new virus was responsible for the majority of post-transfusion hepatitis followed by Houghton M who cloned the virus and developed the blood test to identify those cases that carried the virus.Finally,the work of Rice C demonstrated that a cloned HCV produced after applying molecular biology techniques could cause long-standing infection and cause the same disease as the one observed in humans.

Home first aid applied by the mother for the treatment of food poisoning for children

Objective(s): The objectives of this study are to assess first aid home for the treatment of food poisoning among children by mother and to find out the relationship between first aid home for the treatment of food poisoning and the demographic characteristics including age of mother, level education of mother, mother’s occupation, and family’s income. Methodology: A descriptive analytical study was conducted on mother who applied home first aid for the treatment of food poisoning in her children. The study was conducted at the emergency unit in Children Welfare Teaching Hospital and Child’s Central Teaching Hospital. Starting from 2nd Dec. 2012 up to the 15th Apr. 2013. To achieve the objectives of the study, a non-probability (purposive) sample of (60) mother reviewed the emergency unit for the treatment of food poisoning in her child suffering from food poisoning and according to special criteria. Data were collected by interview with mother of the child suffering from food poisoning. Instrument validity was determined through content validity, by a panel of experts. Reliability of the instrument was determined through the use of Pearson correlation coefficient for the test-retest approach, which was 0.85. Analysis of data was performed through the application of descriptive statistics (frequency, percentage, and mean of score) and inferential statistics (correlation coefficient and one-way analysis of variance). Results: The results of the study indicated the level mean of scores related to first aid procedures relating to situations that food poisoning when the poisoning occurs and applied by mother was moderate level on half items and high level on half other from items. Conclusion: The study concluded most of mothers don’t have prior knowledge of the procedures used for ambulance cases of food poisoning in children. Recommendations: The study recommend the need to set up educational sessions for families especially the mother about how to first aid food poisoning in children and guide booklets or information sheet should be printed and distributed to mothers and families about food poisoning and first aid it, and these booklets or information sheet should be written in a simple style and handed out freely.

Overview of the Prevalence and Associated Risk, Factors of Lifestyle Diseases in University Students

Background: The prevalence of lifestyle diseases is increasing rapidly in Youths (17 - 25 yrs). Factors such as poor diet, little or no physical exercise, and smoking are major contributors to this increase. Lifestyle diseases in youths present a timeline challenge as disease duration is longer and financial burden more costly. Aim: To analyse and synthesize published literature on the prevalence of and risk factors associated with four lifestyle diseases—obesity, hypertension, diabetes and cancer—in university/college students worldwide. Results: The literature indicates that among lifestyle diseases in university/college students, overweight/obesity (Body Mass Index > 25 kg/m2) had the highest prevalence of 45.6% and duration of approximately 5 years. Cardiovascular diseases and hypertension had lower prevalence rates but prehypertension which lingers >4 years was at 32.0%. Type 1 diabetes mellitus (T1DM) had a fairly high prevalence in college students (21.7%);type 2 diabetes mellitus (T2DM) was found in much lower percentage (12.95%). Cancer had the lowest prevalence of >2% but was increasing in most regions based on the presence of multiple risk factors. Conclusion: Increase prevalence of these diseases in youths indicates that young people are at high risk of developing these diseases due to poor early lifestyle habits. Early corrective measures can reduce the burden of many lifestyle diseases.

Analysis for Change in Health Sector Organization

Health sector organization is discussed in many countries of the world. Organization of sectors of the society is a complex issue. It may look difficult where to start and how to navigate through an analysis of health sector organization. The objective is to present an approach to analysis for change in health sector organization that can result in a broad information basis for choice of new organization. A process based framework to analysis for change in health sector organization was designed. The three major stages of the process are： solving problems by smaller change in organization, smaller or major change in organization and major change in organization. Major change in sector organization has the steps： change in sector organization type, number and bordering of geographic subunits, choice of accountability structure, network organization, internal health sector organization and plan for the change process. A new way for how to perform analysis for change in health sector organization is described. With the approach, improved overall information is likely to be achieved. It can be applied as a first step by countries considering new organization of the health sector. It should be followed up by selecting specific organizational alternatives for more detailed analysis. The described framework can help navigating through analysis for choice of future health sector organization.

A Fatal Case of Chronic Eosinophilic Leukemia Not Otherwise Specified (CEL-NOS) in a 19-Year-Old Male with Acute Transformation into Blast Crisis

Chronic eosinophilic leukemia (CEL) is a rare disorder that is characterized by hypereosinophilia with increased number of blood or marrow blasts (>5% and <20%). CEL is distinguished from hypereosinophilic syndrome (HES) by the presence of eosinophilic clonality. Chronic eosinophilic leukemia not otherwise specified (CEL-NOS) diagnosis is made when no fusion genes are detected by most modern molecular testing, particularly the most common fusion gene FIP1L-1/PDGFRA (Factor Interacting with PAP like-1/Platelet-Derived Growth Factor Receptor Alpha). This disease is very rare, and its description in the literature is not well characterized. We report a fetal case of severe CEL-NOS in a 19-year-old male who presented with a plethora of clinical features consists of constitutional symptoms, pancytopenia, intravascular thrombosis, acute stroke and endomyocardial infiltrates. The course of his disease was aggressive and resistant to conventional treatment. After a short period of improvement, an acute transformation into blast crisis (BC) had occurred. The diagnosis was confirmed by morphology and immunophenotyping of bone marrow biopsy. The patient eventually died of heart failure and sepsis. To our knowledge this is the first case report of fatal CEL-NOS transforming into severe blast crisis.

Prostate Cancer and Low Back Ache—Evidenced Role of Physiotherapy

Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment for subjects with low back pain. An emerging trend with Independent physiotherapy practice, knowing red flags, conditions requiring investigations and experts treatment were to be recognized and adhered for maximizing patients care and benefits. Prostate cancer among men above 50 years were more found to be linked with Low back pain. This original research presentation where a subject having chronic low back pain found to have prostate cancer were analyzed and discussed with scientific evidence on clinical manifestations, investigations and medical management. Underlines the importance of recognizing, directing and getting treated of the root cause of subjects suffering with Low back pain due to prostate cancer and not just keep treating the symptoms alone were major purpose of this study.

History,origin,transmission,genome structure,replication,epidemiology,pathogenesis,clinical features,diagnosis,and treatment of COVID-19:A review

In December,2019,pneumonia triggered by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)surfaced in Wuhan,China.An acute respiratory illness named coronavirus disease 2019(COVID-19)is caused by a new coronavirus designated as SARS-CoV-2.COVID-19 has surfaced as a major pandemic in the 21st century as yet.The entire world has been affected by this virus.World Health Organization proclaimed COVID-19 pandemic as a public health emergency of international concern on January 30,2020.SARS-CoV-2 shares the same genome as coronavirus seen in bats.Therefore,bats might be its natural host of this virus.It primarily disseminates by means of the respiratory passage.Evidence revealed human-to-human transmission.Fever,cough,tiredness,and gastrointestinal illness are the manifestations in COVID-19-infected persons.Senior citizens are more vulnerable to infections which can lead to dangerous consequences.Various treatment strategies including antiviral therapies are accessible for the handling of this disease.In this review,we organized the most recent findings on COVID-19 history,origin,transmission,genome structure,replication,epidemiology,pathogenesis,clinical features,diagnosis,and treatment strategies.

世界卫生组织对BPaLM方案治疗耐多药结核病指南的解读

耐多药结核病仍是人类健康的重大危险因素,近期世界卫生组织推荐贝达喹啉(bedaquiline,Bdq)、普托马尼(pretomanid,Pa)、利奈唑胺(linezolid,Lzd)和莫西沙星(moxifloxacin,Mfx)的6个月方案(BPaLM)治疗耐多药结核病。新指南中短程方案适用人群扩大到耐多药结核病患者,而且适用于病变广泛的肺结核和大多数肺外结核,无疑是耐多药结核病治疗的重要事件。本文就BPaLM方案的研究历程、适用人群和注意事项作一简要介绍。

世界卫生组织数字健康治理决策证据研究

目的对世界卫生组织发布的数字健康文件开展科学计量分析,为提升我国数字健康治理能力和治理水平,扩大我国在全球健康决策方面的影响力提供参考。方法识别世界卫生组织发布的数字健康文件引文类型,并开展科学计量,包括统计发文机构、国别、年份并分析引文主题等。结果世界卫生组织在数字健康领域发布多个战略和指导性文件,参考文献为电子文献、期刊文献和少量专著,电子文献以国际机构发布的各类文件为主。期刊论文来自多个医学相关高水平期刊,文献具有较强时效性,研究主题包括随机对照试验、队列研究、卫生教育、行为干预、吸烟、基础设施建设等。美国、英国和瑞士机构的研究成果获得最多引用。结论应合理采纳不同类型机构研究成果,科学优化我国数字健康在重点疾病领域的规划措施,积极参与全球数字健康治理,鼓励我国有能力的社会组织、高校等机构世界卫生组织和其他国际组织研究项目并扩大成果影响力,加强国际合作。